Uterine Cancer is often diagnosed when a woman who is having symptoms and underwent uterine biopsy or D&C. Diagnosis is often followed by surgery to treat and find out the stage of the cancer.
This operation includes removing the uterus, fallopian tubes, and ovaries (total hysterectomy bilateral salpingo-oophorectomy or TH/BSO). Lymph nodes from the pelvis and around the aorta may also be removed and examined for cancer spread. Pelvic washings may be done, too. The tissues removed at surgery are examined under a microscope to see how far the cancer has spread (the stage). Depending on the stage of the cancer, other treatments, such as radiation and/or chemotherapy may be recommended.
For some women who still want to be able to get pregnant, surgery may be put off for a time and other treatments tried instead.
If the cancer has spread outside the uterus, a different surgery may be planned. If the cancer has spread to the inside of the liver, the lungs, or other organs, surgery may not be helpful, and so chemotherapy or other treatments may be used instead.
Uterine Cancer stage I - if the cancer is limited to the body of the uterus and has not spread to lymph nodes or distant sites. Surgery and other treatment often differ for cancers that aren′t uterine tumours.
Standard treatment includes surgery to remove and to find out the stage of the cancer.
Stage I cancers that have been staged with surgery may not need any further treatment. For some patients, especially those with higher grade tumors, doctors are more likely to recommend radiation after surgery. Either vaginal brachytherapy (VB), pelvic radiation, or both can be used.
Some younger women with early Uterine Cancer may have the uterus removed without removing the ovaries. Although this does increase the chance that the cancer will come back, it doesn’t make it more likely that you will die from your cancer.
Women who cannot have surgery because of other medical problems or who are frail due to age are often treated with radiation alone.
Fertility-sparing treatment for stage IA grade 1 cancers: In young women who still want to have children, surgery may be postponed for a time while progestin therapy is used to treat the cancer. Progestin treatment, as a pill, injection, or as a progestin-containing intrauterine device, can cause the cancer to shrink or even go away for some time, giving the woman a chance to get pregnant. This approach is experimental and can be risky if the patient isn′t watched closely.
Often, this does not work and the cancer doesn’t get better or keeps growing. Putting off surgery can give the cancer time to spread outside the uterus. If the cancer doesn’t go away, surgery to remove and stage the cancer is recommended (including a hysterectomy and removal of both fallopian tubes and ovaries).
Sometimes the tumor gets smaller or goes away for a while, but then comes back again. Because the cancer often comes back again, doctors often recommend surgery to remove the uterus, fallopian tubes, and ovaries after childbearing is complete.
A second opinion from a gynecologic oncologist and pathologist (to confirm the grade of the cancer) before starting progestin therapy is important. Women need to understand that this is not a standard treatment and may increase risk.